Buyun Liu1, Yangbo Sun1, Linda G Snetselaar1, Qi Sun2,3, Quanhe Yang4, Zefeng Zhang4, Liegang Liu5,6, Frank B Hu2,3,7, Wei Bao1,8,9. 1. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. 4. Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 5. Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 6. Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Wuhan, China. 7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 8. Obesity Research and Education Initiative, University of Iowa, Iowa City, Iowa, USA. 9. Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA.
Abstract
BACKGROUND: A diet high in trans-fatty acids (TFA) induces insulin resistance in rodent models and primates. However, previous epidemiological studies on the association between TFAs, based primarily on self-reported intake from the diet, and diabetes in humans have yielded conflicting results. Herein we examined the associations of objectively measured plasma TFA concentrations with diabetes in a large population-based study among US adults. METHODS: We included 3801 participants aged ≥20 years from the National Health and Nutrition Examination Survey 1999-2000 and 2009-10. Four major TFAs, namely palmitelaidic acid (C16:1 n-7t), elaidic acid (C18:1 n-9t), vaccenic acid (C18:1 n-7t), and linolelaidic acid (C18:2 n-6t, 9t), were measured in fasting plasma using gas chromatography-mass spectrometry. Diabetes was defined by self-reported physician diagnosis, plasma fasting glucose ≥126 mg/dL, or HbA1c ≥6.5%. RESULTS: After adjustment for other major risk factors, the odds ratios (95% confidence intervals) of diabetes comparing the highest with lowest quintile of plasma TFAs was 2.19 (1.27-3.79) for total TFAs (Ptrend = 0.01), 2.34 (1.48-3.72) for elaidic acid (Ptrend = 0.0004), 1.33 (0.82-2.15) for linolelaidic acid (Ptrend = 0.18), 1.58 (0.97-2.58) for palmitelaidic acid (Ptrend = 0.02), and 1.64 (0.95-2.84) for vaccenic acid (Ptrend = 0.08). In addition, total TFAs, elaidic acid, palmitelaidic acid, and vaccenic acid were significantly associated with fasting glucose, fasting insulin, the insulin resistance index, and HbA1c. CONCLUSIONS: In a nationally representative population, plasma TFAs, in particular elaidic acid, were positively associated with diabetes and biomarkers of glucose metabolism.
BACKGROUND: A diet high in trans-fatty acids (TFA) induces insulin resistance in rodent models and primates. However, previous epidemiological studies on the association between TFAs, based primarily on self-reported intake from the diet, and diabetes in humans have yielded conflicting results. Herein we examined the associations of objectively measured plasma TFA concentrations with diabetes in a large population-based study among US adults. METHODS: We included 3801 participants aged ≥20 years from the National Health and Nutrition Examination Survey 1999-2000 and 2009-10. Four major TFAs, namely palmitelaidic acid (C16:1 n-7t), elaidic acid (C18:1 n-9t), vaccenic acid (C18:1 n-7t), and linolelaidic acid (C18:2 n-6t, 9t), were measured in fasting plasma using gas chromatography-mass spectrometry. Diabetes was defined by self-reported physician diagnosis, plasma fasting glucose ≥126 mg/dL, or HbA1c ≥6.5%. RESULTS: After adjustment for other major risk factors, the odds ratios (95% confidence intervals) of diabetes comparing the highest with lowest quintile of plasma TFAs was 2.19 (1.27-3.79) for total TFAs (Ptrend = 0.01), 2.34 (1.48-3.72) for elaidic acid (Ptrend = 0.0004), 1.33 (0.82-2.15) for linolelaidic acid (Ptrend = 0.18), 1.58 (0.97-2.58) for palmitelaidic acid (Ptrend = 0.02), and 1.64 (0.95-2.84) for vaccenic acid (Ptrend = 0.08). In addition, total TFAs, elaidic acid, palmitelaidic acid, and vaccenic acid were significantly associated with fasting glucose, fasting insulin, the insulin resistance index, and HbA1c. CONCLUSIONS: In a nationally representative population, plasma TFAs, in particular elaidic acid, were positively associated with diabetes and biomarkers of glucose metabolism.
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